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背景:脑卒中及脑损伤所致偏瘫后易造成继发性骨质疏松,其骨密度值和骨矿含量是预测骨质疏松骨折的危险性的有效参数。目的:通过对偏瘫患者骨密度值及骨矿含量的测定与分析,探讨偏瘫患者骨质疏松发生的特点。设计:病例分析。对象:选择1999-03/2002-05在北京博爱医院神经康复科住院的偏瘫患者156例。男87例,女69例;年龄17～65岁,平均年龄(47.0±5.3)岁;病程19d～1年,平均病程(5.0±3.5)个月;疾病类型:脑梗死89例,脑出血67例;瘫痪侧别:左侧79例,右侧77例。方法:所有患者使用LUNAR 双能X 射线骨密度仪从头部至足部进行全身扫描,测量骨密度和骨矿含量。主要观察指标:①不同病程偏瘫患者中骨质疏松发生率。②不同部位瘫痪患者的骨矿含量。结果:156例患者全部进入结果分析。①病程在3～6个月骨质疏松发生率最高(44%,16/36),病程在9～12个月骨质疏松发生率最低(21%,7/33),总体骨质疏松发生率为31%(48/156)。②病程在3个月内:47例患者中有9例为弛缓性瘫,均患有骨质疏松,其中2例发生骨折。病程3～6个月:36例患者中有3例为弛缓性瘫,也患有骨质疏松。③上肢患侧的骨矿含量明显低于健侧犤(154.76±43.91)g,(172.59±43.78)g,(t=3.591,P <0.001)犦。下肢患侧的骨矿含量与健侧基本接近犤(463.41±309.28)g,(464.11±86.45)g,(t=0.027,P >0.05)犦。结论:偏瘫患者的骨量变化随偏瘫时间的不同有不同的变化。上肢患侧的骨矿含量低,下肢患侧骨矿含量接近正常,这是由于下肢较早的进行功能锻炼,说明骨量的大小与运动有密切关系。
Background: Secondary osteoporosis is easily caused by hemiplegia after stroke and brain injury. Its BMD and bone mineral content are effective parameters for predicting the risk of osteoporotic fracture. Objective: To explore the characteristics of osteoporosis in patients with hemiplegia by measuring and analyzing bone mineral density and bone mineral content in patients with hemiplegia. Design: Case Analysis. PARTICIPANTS: 156 patients with hemiplegia who were hospitalized in Department of Neurology and Rehabilitation, Beijing Pok Oi Hospital from March 1999 to May 2002 were selected. There were 87 males and 69 females, aged from 17 to 65 years, with an average age of 47.0 ± 5.3 years. The duration of disease ranged from 19 days to 1 year (mean 5.0 ± 3.5 months). The types of diseases were cerebral infarction (89 cases), cerebral hemorrhage Cases; paralyzed side: the left 79 cases, the right 77 cases. METHODS: All patients underwent whole-body scanning from head to foot using LUNAR Dual Energy X-ray absorptiometry to measure bone mineral density and bone mineral content. MAIN OUTCOME MEASURES: ① The incidence of osteoporosis in patients with hemiplegia with different course of disease. ② different parts of patients with paralyzed bone mineral content. Results: All 156 patients entered the result analysis. ① The duration of osteoporosis was the highest (44%, 16/36) in 3 ~ 6 months. The duration of osteoporosis was the lowest (21%, 7/33) in 9 ~ 12 months. The overall incidence of osteoporosis The rate was 31% (48/156). ② course of disease within 3 months: 47 patients in 9 cases of flaccid paralysis, are suffering from osteoporosis, of which 2 cases of fracture. Course of 3 to 6 months: 36 patients in 3 cases of flaccid paralysis, also suffering from osteoporosis. ③ The content of bone mineral in the affected side of the upper limb was significantly lower than that of the healthy side (154.76 ± 43.91) g, (172.59 ± 43.78) g (t = 3.591, P <0.001). The bone mineral content and contralateral side of lower extremity were close to 犤 (463.41 ± 309.28) g, (464.11 ± 86.45) g, (t = 0.027, P> 0.05) 犦. Conclusion: The bone mass changes in patients with hemiplegia vary with the time of hemiplegia. Upper limb ipsilateral bone mineral content is low, lower extremity ipsilateral bone mineral content close to normal, which is due to lower extremities earlier functional exercise, indicating that the size of bone mass and exercise are closely related.